PET in breast cancer
Whole-body PET scanners are not optimal for the evaluation of primary breast cancer, but have been used for the staging of metastatic disease beyond the breast. High-resolution dedicated breast PET scanners offer 1.5-2.0 mm spatial resolution, allowing for reliable detection of even small lesions (García Hernández et al., 2016; O’Connor et al., 2017).
[18F]FDG is the most used PET tracer for breast cancer imaging, but other tracers could be used as well (Wahl et al., 1993; Fowler, 2014; Lebron et al., 2015; Dalm et al., 2016). Dynamic [18F]FDG PET can provide both K1 and Ki, which predict disease-free survival better than SUV from static imaging (Dunnwald et al., 2011).
Amino acid tracer [18F]fluciclovine is used for the detection of recurrent prostate cancer, but it has also shown promise in imaging of breast cancer (Ulaner et al., 2018). L-[11C]methionine is also useful for detecting breast cancer (Leskinen-Kallio et al., 1991a; Huovinen et al., 1993).
Gastrin-releasing peptide receptors are overexpressed in breast cancer, and specific PET tracers have been used to detect the tumours.
Perfusion in breast tumours has been studied using radiowater PET, and the initial uptake rate of other tracers, such as FDG (Eby et al., 2008; Specht et al., 2010). [18F]fluoride PET can be used to estimate perfusion and fluoride uptake in bone metastases (Doot et al., 2010), but not in primary breast cancer (Sarikaya et al., 2018).
Bombardieri E, Bonadonna G, Gianni L (eds.): Breast Cancer - Nuclear Medicine in Diagnosis and Therapeutic Options. Springer, 2008. ISBN 978-3-540-36780-2. doi: 10.1007/978-3-540-36781-9.
Piccart MJ, Wood WC, Hung C-M, Solin LJ, Cardoso F (eds.): Breast Cancer and Molecular Medicine. Springer, 2006. ISBN 978-3-540-28265-5. doi: 10.1007/978-3-540-28266-2.
Updated at: 2018-12-24
Created at: 2018-01-09
Written by: Vesa Oikonen